In the dental field periodontal disease is known to be a progressive, plaque-induced disease. Periodontal disease can cause serious tissue inflammation and even bone loss in the areas surrounding the teeth of those afflicted. To effectively treat periodontal disease it is essential to monitor the progression of the disease in the mouths of patients. To monitor the progression of periodontal disease a dental professional periodically measures the depths of the periodontal pockets surrounding the teeth.
The periodontal pocket is the physical distance from the top of the gingival tissue surrounding a tooth, to the depth that a probe will physically extend, until contact pressure impedes the probe from entering the pocket any further. This is usually at the level where the epithelial attachment starts between the gum and tooth root. As periodontal changes occur, the relative depth of the periodontal pocket increases. Measurements are usually taken in millimeters.
In the dental setting, accurately and thoroughly measuring the peridontium can be time consuming and tedious. Conventional probing, still utilized by most dental offices, requires the operator to stop and record the depth of the periodontal pocket at least after the measurement of every tooth, or an assistant is required to record the measurements. Traditionally, the measurements are manually written on the patient's chart. The process of measuring and recording is repeated for each periodontal pocket to be measured.
Conventional probes have lines, marks or colours to indicate the depth that the probe penetrates into the pocket between the tooth and the gum. The dental professional has to manually read the depth of the probe. Probes are small and such readings are difficult to make accurately. Very small differences can be important in monitoring the progression of periodontal disease. There is also a problem of subjectivity. Different dental professionals may have different techniques or may view the periodontal probe at a different angle when taking measurements on different days. Different measurement techniques are a significant problem in offices with multiple hygienists or dentists, as each practitioner could employ a different measuring technique for the same patient during different visits.
Aside from conventional graduated probes, many instruments exist to measure the depth of the periodontal pocket. One of these devices is the electronic periodontal probe with a constant force applier, also known by the trademark FLORIDA PROBE™, which is described in U.S. Pat. No. 4,791,940, and Canadian Patent No. 1,282,236 to Hirschfeld et al. This probe and recording apparatus uses a spring tension device electronically connected by a transducer to the recording apparatus. The probe tip, attached to a movable or mechanical arm, moves within a narrow sleeve fixed to a probe handle. When the probe tip rests at the bottom of the pocket, the probe handle is pressed until the sleeve end touches the gingival margin. The subsequent exposed length above the sleeve represents the depth of the pocket. A foot switch triggers electronic measurement from the mechanical displacement of the transducer to the recording apparatus. This probe has several disadvantages. First, the mechanical moving parts in the narrow sleeve, arm, handle and spring are all subject to loss of integrity that may change the consistency of the force required to allow spring tension transduction. Second, the probe tip needs to be removed for sterilization. Third, the height from probe tip to the top of the mechanical moving arm may make it difficult to obtain readings in the back of the mouth where there is less room. Furthermore, the size may make it difficult to get proper readings in patients with limited opening ability.
U.S. Pat. No. 4,995,403 to Beckman et al. describes a periodontal probe with a retractable fiber element for measuring. Again, there are movable parts that are subject to frictional inaccuracies in measurement. Also, a large portion of the instrument is not sterilizable and needs to be disposed of, making the overall length of the device substantial. The large length can create issues in positioning the probe for measuring and can be cumbersome and uncomfortable for a dental professional to use.
Another example of a movable sleeve and tip is described in U.S. Pat. No. 5,993,209 to Matoba et al. This device detects positional differences between the tip of the probe and the tip of the sleeve when the tip of the probe is inserted into the bottom of the pocket and the sleeve is at the top of the gingiva. Again, movable parts are a disadvantage and all the components comprising the apparatus that move could add to inaccuracies due to friction during movement of the probe within the sleeve, at the elbow, or along the terminal sleeve.
In the past, to reduce time and produce consistency with periodontal probing examinations, attempts have been made to produce periodontal probes that will electronically record the depth of periodontal pockets. One disadvantage of these probes is that they have movable parts that can lead to difficulties with sterilization, and inconsistency in the overall measurements. Moreover, these probes tend to be large and bulky.
The prior art lacks probes that can quickly and easily determine the depth of the periodontal pocket by measuring the amount of marginal tissue without relying on the dental professional's technique. The prior art also lacks a probe that compiles electronic measurements, is lightweight, provides consistent accuracy, and is easy to sterilize.